You finally book your dream cruise to that tropical Eden with the sugar-sand beaches and azure waters as intoxicating as the rum-spiked tall ones served at the native gin mills.
You can see it now: You're standing tall at the bow, frosty cocktail in hand, sultry trade winds gently kissing your face, salty spray stinging your nostrils, and you marvel at the undulating waters.
Too often, however, the gut-wrenching reality of motion sickness intrudes on that dream sequence. Rather than peering over the ship's bow at boundless Oceanus, many summer travelers become more acquainted with the swirling blue waters of a much smaller bowl.
For some 50 million Americans, motion sickness is the killjoy that threatens to turn a dream vacation into a recurring gastrointestinal nightmare.
"You can feel a bit queasy, a little bit off, and then it can become quite severe," says Dr. Kenneth Dardick, director of Connecticut Travel Medicine in Storrs. "There's a bad joke about it: At first you're afraid you're going to die, then after a while, you're afraid you're not."
But the symptoms are no laughing matter, he says, for the people who suffer motion sickness, which any type of transportation from cars to roller coasters can trigger.
Doctors aren't quite sure what causes it. They suspect a disconnect between the eyes and the inner ear. When you look out at a horizon the eyes see flatness -- and no motion -- but the inner ear may be experiencing motion.
"What does the brain do? It can't compute and that creates a short circuit," Dardick says.
Some people seem resistant to motion sickness -- people who are stone deaf, for instance, are spared that agony -- while others can watch a roller coaster snake along the tracks in a movie become queasy. Motion sickness can strike suddenly, progressing from a feeling of restlessness to cold sweats, dizziness, vomiting, and diarrhea. Symptoms usually resolve once the motion stops. As with sailors who develop "sea legs" during extended voyages, the longer you travel, the greater the chance you'll adjust to being in motion.
But why plan to adjust when you can sidestep motion sickness by planning?
"There are many simple tips people can follow to curb the feeling of motion sickness," says Patti Blau, a vestibular therapist and assistant professor of physical therapy at UT Southwestern Medical Center at Dallas.
Like bypassing burritos and booze. Most people know that reading while traveling can provoke motion sickness, but many are unaware that alcohol and spicy or greasy foods may also stoke that queasy feeling.
If you are planning to fly, travel at non-peak times and arrive early to reduce stress. Also, try to book a seat over the wing because it "provides the passenger with a more stable feeling," Blau says.
Motorists who've had a previous bout of motion sickness should sit in the front seat so you can take in the scenery at a distance.
Should these measures still leave you a bit green around the gills, get thee to the medicine cabinet.
Consider over-the-counter antihistamines, such as Diphenhydramine (Benadryl), dimenhydrinate (Dramamine), cyclizine (Marezine), and meclizine (Bonine). These drugs are effective, but can put you to sleep.
What works best of all, says Dr. Richard Hornick, medical director for Health Services for Travelers with Orlando Regional Healthcare, is scopolamine, which is available in a prescription stick-on patch. The patch is worn behind the ear several hours before your trip, and provides 72 hours of protection. Because the medication is slowly absorbed through the skin the side effects are minimal. The patch, however, may not be recommended for people with health problems such as asthma, glaucoma or urine retention.
For stomach woes, Holly Vance, a clinical pharmacist for drugstore.com, suggests ginger to help prevent and treat mild nausea. Ginger, taken 30 minutes before traveling and every two hours after as needed, works for up to 40 percent of those who take it, she says.
Meanwhile, the motion sickness market is booming with all manner of wristbands that promise relief without drugs and side effects. Products such as Sea-Band and ReliefBand purportedly control the symptoms through accupressure or electrical signals to stimulate nerves in the wrist.
Many people swear by the bands, Hornick says, though little conclusive research exists. The benefits may be a case of the placebo effect, he says.
In any case, prevention is the best medicine. Waiting until the symptoms hit can be costly. Or as Dardick, the clinician, puts it: "Once it sets in, you're dead meat."